Hepatic function immediately after hepatectomy as a significant risk factor for early recurrence in hepatocellular carcinoma

BACKGROUND/AIMS: The aim of this study was to clarify the significant risk factors as they relate to early recurrence after hepatectomy in cirrhotic p atients with hepatocellular carcinoma (HCC). METHODOLOGY: We retrospectively investigated 42 cirrhotic patients undergoi ng hepatectomy for a single HCC. We compared the clinicopathologic features of 14 patients with early intrahepatic recurrence (recurrence was detected within I year after hepatic resection; Group 1) with 28 patients without r ecurrence or with late intrahepatic recurrence (recurrence was confirmed mo re than 1 year after hepatic resection; Group 2). RESULTS: There were no significant differences in the pre-operative and int ra-operative clinical background data or pathological data between the 2 gr oups. Regarding recurrence pattern, although not significant, the incidence of intrahepatic metastasis in Group 1 (85.7%) was higher than in Group 2 ( 50.0%). Maximum values of total bilirubin and albumin within 7 days after h epatectomy for patients in Group 2 were significantly better than those in Group 1. Asparate aminotransferase (AST) and alanine aminotransferase (ALT) immediately after hepatectomy in Group 1 were also higher than in Group 2, although statistically insignificant. The overall 1-year and 3-year surviv al rates between Group 1 versus Group 2 were 85.7% versus 100% (p<0.01) and 57.2% versus 90.0% (p<0.01), respectively. CONCLUSIONS: Hepatic functional damage immediately after hepatectomy is as significant risk factor for early intrahepatic recurrence in cirrhotic HCC. Careful perioperative management of hepatic function may therefore be impo rtant in preventing early recurrence and prolonging survival.